Insulin resistance syndrome
Insulin is a hormone that allows the introduction and use of sugar in the muscles and fat tissue. Insulin resistance is the decrease in insulin-mediated effect and insulin sensitivity. Insulin resistance syndrome is a disease that can be seen in children. When insulin resistance develops, an increase in sugar output from the liver and a response to insulin at the physiological level, blood sugar is increased due to reduced intake of sugar into the cell.Insulin structure divided into a and b . Genetic and non-genetic causes are responsible for resistance formation. Non-genetic causes; low birth weight, obesity, sedentary lifestyle, nutritional error. you should research for information about the structure of insulin.
What are the conditions that accompany insulin resistance?
Insulin resistance; it is often seen with obesity, not in any obese individual, but also in non-obese children and adults. Insulin resistance can also be seen in pregnancy and adolescence with normal physiological periods. In healthy children with a family history of type 2 diabetes, the balance between insulin sensitivity and release is impaired. Abdominal (abdominal / waist circumference) increase in adipose tissue is associated with insulin resistance independent of total body fat.
Insulin has a similar function to leptin, which is secreted from adipose tissue and is known as the saturation signal. When the weight increases, the secretion of insulin increases with the aim of achieving normal glucose balance and defeating the resistance. The level of insulin in obese patients is parallel to the duration and severity of obesity.
Insulin resistance is the precursor of type 2 diabetes. Insulin resistance is the underlying cause of many metabolic and cardiovascular problems associated with obesity. In recent years, the prevalence of hypertension, dyslipidemia (LDL cholesterol and triglyceride elevation, low HDL cholesterol), type 2 diabetes, and insulin resistance in obese children and adolescents are explained by insulin resistance. In insulin resistance, bulging thickening is usually seen in the back of the neck, underarm and other fold.
Insulin resistance leads to an increase in androgenic activity and thus hair growth in the early armpits and genital areas in children and in other areas. Insulin resistance is the main cause of polycystic ovary syndrome, which is characterized by menstrual irregularity, androgen height, hair and obesity. Insulin resistance, non-alcoholic liver fatigue, increased uric acid level, cardiovascular disease and tendency to coagulate increases.
How to feed a child with insulin resistance?
In children and adolescents with insulin resistance, a nutritional plan should be made that will not prevent growth, contain age-appropriate calories, protein, fat and carbohydrate are balanced. In this nutritional model, saturated fat content should be low, simple sugar-containing beverages and foods, high-calorie fast food foods should not be consumed. Whole-grain bread and high pulp content (fruits, vegetables and legumes) foods should be preferred.
Fresh fruit instead of fruit juice should be preferred 2-3 servings per day, foods with high glycemic index (rice pilaf, pasta, pastries, toast, banana, sugary drinks etc.) should not be consumed frequently, high-calorie-free foods (dry nuts, buttermilk, yogurt and Be careful not to have foods like fruits). Lifestyle change is a must. Alongside proper nutrition, general mobility and a regular exercise program increase insulin sensitivity, independently of both obesity and obesity, thereby reducing insulin resistance.
What needs to be done in order not to occur?
Insulin resistance can be prevented from pregnancy. The excessive weight gain or malnutrition of the mother during pregnancy, pregnancy diabetes, smoking during pregnancy, disrupting the metabolic programming of the baby, increase the tendency to obesity and insulin resistance at later ages. Healthy nutrition of the mother during pregnancy, the normal amount of weight gain and prevention of pregnancy diabetes reduces this risk. Rapid weight gain after childbirth increases the risk of developing fast growth, obesity and insulin resistance, especially in low-birth-weight cases. Therefore, in the first 6 months, the main diet should be breast milk.
Breast milk prevents obesity and reduces the likelihood of potential insulin resistance in older ages. In addition to supplemental foods, low glycemic index and saturated fat-free diet increase insulin sensitivity. Adoption of the right diet and mobile lifestyle and the replacement of vitamin D deficiency, if any, prevent the development of insulin resistance in the pediatric age group to prevent excessive weight gain.
Obesity Affects Children’s School Success! In obese children, sleep apnea, fatty liver, joint and bone problems, as well as problems such as hepatitis, psychological problems are more common than their peers. Research shows that fat children have lower self-esteem and higher depression and anxiety scores. It is also noted that these children have low academic performance at school.
What is Insulin Resistance?
Let’s talk about insulin before defining insulin resistance.
It is a hormone that regulates sugar metabolism secreted from the pancreas. Insulin is bound and activated by a so-called ”insulin receptor t when making this arrangement. If this receptor does not allow insulin binding for various reasons; insulin in the blood is enough to give the impression that the task is not.
Insulin resistance can be defined as the difficulty in demonstrating the effect of insulin secreted to control sugar in the body. Under normal conditions, body glucose can be controlled by 1 unit of insulin, while in patients with insulin resistance, the body will have to release 2-3 units of insulin. As insulin resistance increases, insulin is also increased to ensure sugar control.
This means excessive insulin secretion in the body. The increasing frequency of obesity and diabetes in the world and in our country brings about the metabolic problem called insulin resistance . Increased fat in the body causes insulin resistance, insulin resistance increases the body’s fat ratio, that is, obesity. In order to treat insulin resistance affecting many systems such as protein metabolism, reproduction and immunity, first of all, nutrition and exercise habits should be reviewed.
Insulin resistance causes insulin storage in the body, resulting in weight gain, fatty liver, and cardiovascular diseases. Those who have insulin resistance problems have difficulty in losing weight even if they do sports and balanced diet. Because insulin is too secreted, it causes the stored foods to be stored as fat. Insulin, which has to be released more and more, tends to overwhelm the pancreas over time. Insulin resistance may lead to a severe picture of pancreatic insufficiency and diabetes.
The place of nutrition in insulin resistance is very important. It has become easier for us to reach the food from the first ages to the present day, and the caloric values of the nutrients that have been reached in reverse proportion have also increased every passing century. This progress in technology has led to more computer-focused working styles in an office environment. Immobility and fast food consumption in the office environment confronts employees with obesity. The requirement to consume plenty of calorie nutrients quickly makes it difficult to lubricate the waist circumference when combined with the lack of movement; this causes the onset of insulin resistance syndrome.
Symptoms of Insulin Resistance
Insulin resistance is the inability of insulin to show its biological effects in glucose, fat and protein metabolism, although it is present in the circulation. Metabolic deterioration, which is caused by the decrease of glucose usage in the tissues and increased glucose production in the liver, is the basis of insulin resistance.
Insulin resistance is accompanied by type 2 diabetes, hypertension, lipid elevation, polycystic ovary syndrome. In assessing the metabolic status associated with insulin resistance, fasting and postprandial blood glucose, HbA1c values should be considered. Candy loading test (oral glucose tolerance test) can be performed where necessary. Waist circumference of patients with insulin resistance and metabolic syndrome is important. Waist circumference of 80cm in women, men over 94cm in individuals with;
- Fasting blood sugar height from 100 mg / dl • Use of antihypertensive drugs with blood pressure above 130-85 mmhg or diagnosis of hypertension
- If there are at least two of the criteria such as triglyceride level of more than 150 mg / dl or HDL-cholesterol (good cholesterol) in women less than 40mg / dl in men, evaluation is made by considering the presence of insulin resistance. Insulin resistance or insulin resistance is seen more frequently in the relatives of people with type 2 diabetes by the influence of genetic factors. In addition, factors such as sedentary life and excess calorie feeding also lead to the development of insulin resistance. Muscles are tissues that are affected by fat tissue and liver.
Symptoms of insulin resistance;
- After a heavy meal, after eating a sugary food, the feeling of excess weight, drowsiness; • Hand shake, sweating, when sugar begins to fall uncontrolled after eating.
* Stomach scratching complaints;
- Unable to control weight gain
- Frequent sweet eating request
- •Widening of waist circumference
- Browning of armpits, groin, neck areas called ‘Akantosis Nigrikans
- Liver lubrication
- Menstrual irregularities in women. An endocrinology or internal medicine specialist should be consulted as soon as you notice the symptoms of insulin resistance.
How Is Insulin Resistance Calculated?
Insulin resistance causes many important diseases such as diabetes, heart disease and metabolic syndrome. Metabolic syndrome is accompanied by very serious problems such as insulin resistance, elevated blood insulin, obesity, hypertension, high cholesterol levels and obstruction of the coronary arteries. At the same time, insulin resistance may cause health problems such as polycystic ovary syndrome in young women. The relationship between insulin resistance and weight is defined as a vicious cycle.
- Fatigue and weight gain = Insulin resistance = Fatigue“. An easy way to get rid of this vicious cycle is to measure insulin resistance in a fully equipped hospital and take control by specialists. In our country, a study called Metsar sendrom about metabolic syndrome caused by insulin resistance was performed. As a result of the research conducted on a group over 4 thousand people, the rate of metabolic syndrome in our country was found to be 33%. As a result of this study, it is important that most of the patients with metabolic syndrome are not aware of the disease. Some of the interesting data in this study are as follows;
- • 27.6% of people over 20 years of age are high in sugar but unfortunately they are not aware of this. These people are at risk for diabetes and need to receive insulin resistance therapy. • 54.8% of Turkish women are obese and are therefore at risk for heart attacks and diabetes. These results show that insulin resistance is an important and progressive disease.
- In our country insulin resistance and accordingly; obesity, diabetes and heart attacks will increase day by day. Our duty is to make our controls and to take precautions beforehand. Insulin Resistance Test One can also understand whether there is insulin resistance by questioning the daily routine. According to this, the questions that the individual has to ask yourself are:
- called junk food; Am I consuming cookies, chips, popcorn foods? • Does my blood pressure rise above 140-90?
- Is it a problem to lose weight despite regular sports or exercise?
- Is my waist thickness too high? (Is there an accumulation of fat around the waist?) • in my family; Do you have diabetes or heart disease, high blood pressure, polycystic ovarian disease and obese individuals?
- Fit after eating, experiencing difficulty concentrating, imbalance and headache?
- Do I have a high cholesterol level?
- Do I need to eat sugar and pastry suddenly?
- Do I feel tiredness and drowsiness after every meal? • Has fasting blood sugar been detected?
- Do I exercise less than 2 times a week? Test results Based on the number of YES responses given to the above questions, an assessment is made on the risk of insulin resistance in the individual. Insulin Resistance Therapy The primary step in the treatment of insulin resistance is lifestyle changes. It is important that medical nutrition therapy, exercise and movement increase, sleep patterns are maintained and sustainable.
Medical nutrition therapy in the treatment of insulin resistance;
- It is determined according to individual’s age, gender, physical activity and life style.
- The insulin resistance diet should contain all nutrients in an adequate and balanced manner. • Short-term shock programs should not be implemented.
- It should be aimed to reduce approximately 5-10% of body weight in 6 months. The daily calorie intake of the individual should be calculated and the average should be reduced to 400-600 kcal.
- •A weight loss of 0.5-1 kg per week should be targeted.
- A sustainable, feasible and delicious program should be prepared.
- Balanced nutrition program should consist of 4-6 meals. Frequent feeding prevents overproduction at the next meal.
- Daily protein intake should account for 20-35% of total calories. Adequate intake of protein is important in terms of satiety and maintaining lean body mass.
- 25-35% of daily calories should be taken from the oils.
- As the absorption of fat-soluble vitamins (A, D, E, K) may be adversely affected, the fat content should not be reduced much.
- 50-65% of daily calorie should be taken from carbohydrates.
- Instead of simple carbohydrates (such as sugar), complex carbohydrates (whole grain products, legumes) should be preferred. Some medications may be recommended to patients who cannot or cannot benefit from lifestyle changes. It shows the effect of appetite and mild weight loss. Metformin, especially HbA1c 5.7-6.4% between fasting and / or toughness blood glucose levels above the normal, with a history of gestational diabetes, the body mass index reduces the risk of developing diabetes in patients greater than 35% 30%.
how to correct insulin resistance?
In the treatment of insulin resistance, first a blood test is performed to measure the resistance level. For people with high resistance, the level can be normalized with 2-3 months or maximum 6 months of treatment. When the insulin resistance level returns to normal, the obstacles to losing weight will be removed. Therefore, patients quickly lose their appetite and lose weight.
In addition, heart disease, predisposition to cancer types and diabetes are also prevented. Medicines also play a major role in the treatment of insulin resistance. When a healthy diet and exercise program together with the necessary drugs are used, the person starts to lose weight. Medications that prevent insulin resistance are drugs used in the treatment of sugar, and within 2-3 months after the insulin resistance is controlled, the level is completely normalized, the drug treatment is terminated.
Thus, weight gain, excessive lubrication, vascular lubrication, atherosclerosis, vascular stiffness, cardiovascular disease risks, liver fatigue risk, especially towards people at risk of diabetes is completely prevented. Insulin resistance is detected especially in patients with diabetes risk, and correct treatment is applied to prevent the disease before the start.
Therefore, it is possible to eliminate the risk of diabetes when insulin resistance is treated in time. Another approach in the treatment of insulin resistance is the promotion of insulin excess not only by the administration of insulin from the outside, but also by some drugs used in the treatment of Type 2 diabetic patients.
For this reason, treatment should be considered completely. The correct and adequate nutrition plan for insulin resistance therapy should be aligned with one’s daily life. Doing so may cause the treatment to be completely uncontrolled. Refined carbohydrates should be restricted as much as possible, and adequate caloric intake should be ensured by focusing on weight control.
The form of nutrition and the preparation of foods are also very important. Meals should be eaten slowly, rather than being chewed, and without saturation. The timing of exercise and nutrition and drug therapy is very important in the treatment of insulin resistance and diabetes. It is not true to expect each patient to behave like an athlete and to force it.
- An adequate level of exercise should be encouraged to do in the most appropriate period. Exercise planning should be done after the complications are evaluated. In the first 30-60 minutes after meals, the habit of sitting and drinking tea should be abandoned. In these periods, it is more accurate to do 10-15 minute walking or table gathering movements.
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